What we eat often has a large impact on our health. With arthritis, this is especially true. While certain diets do not cause arthritis, research has shown that there are many dietary factors that can help to ease the problems and symptoms associated with arthritis – mainly, pain caused from inflammation.

Arthritis literally means inflammation (itis) of the joints (arth). Arthritis is not one disease; it is a term describing more than a hundred different diseases, including osteoarthritis, rheumatoid arthritis, and juvenile arthritis.

If you have any form of arthritis or joint pain, there are many dietary changes that can help reduce inflammation and lead to a more pain-free life.

Increase Dietary Fiber and Reduce Refined Carbohydrates
Consuming a low-fiber diet has been linked to increases in C-reactive protein, which is one of the acute phase proteins that increase during systemic inflammation. Research has shown that diets high in refined carbohydrates, especially white flour and sugar, can lead to inflammation. Refined carbohydrates include white table sugar and white or enriched flour, and all of the products that contain them. Foods high in refined sugar and flour include some cereals, baked goods (cookies, cakes, pies, etc), fruit drinks (other than 100% fruit juices such as orange juice), some salad dressings, white pasta, and white bread.

Here are some practical tips for increasing the amount of fiber in your diet and decreasing the amount of refined carbohydrates:

• Bread – Look for breads with at least 3 grams of fiber or more per slice.
• Fruits and Vegetables - Eat the edible skins on fruits and vegetables such as apples, pears, cucumbers, and tomatoes.
• Pasta – Substitute whole-grain pasta for regular pasta. Look for ingredients such as legume flour and whole-wheat flour.
• Cereals – Choose cereals with at least 5 grams of fiber or more per serving. Look for ingredients such as whole-wheat flour and corn. Sugar should not be listed as one of the first two ingredients.

Consume More Healthy Fats and Less Unhealthy Fats
Hydrogenated and saturated fats have been shown to promote inflammation. On the other hand, healthy fats, especially monounsaturated and omega-3 fats, have been linked to decreased inflammation.

Saturated fat is found mainly in high-fat animal products, such as red meat, organ meats (i.e. liver), whole milk, cheese, sour cream, and ice cream. Trans fat is found in some packaged foods, including cookies, crackers, pastries, margarine and shortening and also in fried foods, such as French fries and doughnuts. Limiting these types of fat is not only good for reducing arthritic inflammation but also for overall health.

Monounsaturated fats include olive oil, avocados and nuts (especially almonds, cashews, and peanuts). The best sources of omega-3 fats are salmon, trout, flaxseeds, flaxseed oil, walnuts, and walnut oil. Most research on omega-3 fatty acids and their role in lessening arthritic inflammation focuses on reducing tenderness in joints, decreasing morning stiffness, and allowing for a reduction in the amount of medication needed for people with rheumatoid arthritis.

Increase B Vitamins
Plasma homocysteine is an amino acid in the blood. High levels of homocysteine are linked with systemic inflammation. Some research has found that higher blood levels of B vitamins are related to lower concentrations of homocysteine and, therefore, reduced inflammation. In particular, increased intake of vitamins B6, B12, and folic acid (vitamin B9) has been shown to help reduce homocysteine levels.

Fortified breakfast cereals are an excellent source of vitamins B6, B12 and folic acid. In addition, vitamin B12 is also found in foods that come from animals, including fish, meat, poultry, eggs, milk and milk products. Other rich sources of vitamin B6 are poultry, pork, fish, milk, eggs, nuts, seeds, brown rice, whole grains, bananas, carrots, avocados, soybeans and whole grains. In addition to fortified cereals, rich sources of folic acid include whole-wheat products, eggs, legumes, liver, leafy greens, oranges, strawberries and melon.

Add Garlic, Ginger and Tumeric
Garlic, ginger and tumeric are known as anti-inflammatory herbs. Ginger and turmeric are both members of the Zingiberaceae, or ginger, family. They are both noted for their antioxidant and antimicrobial activity and have been shown to help decrease inflammation and alleviate pain from arthritis.

Garlic belongs to the Liliaceae, or lily, family. Some studies show garlic to be an antimicrobial, anticancer, cholesterol-lowering, and anti-arthritic agent. Garlic is also an antioxidant.

Adding these potent herbs when cooking can help give your food wonderful flavor while also helping to decrease inflammation and pain from arthritis. Talk to your doctor before taking any of these herbs in supplement form, as high doses can sometimes be harmful.

Drink More Water
Water is essential for life and is important for many bodily functions, like the lubrication and protection of joints. Without enough water, there is increased friction between the cartilage surfaces of the joints. This results in swelling and stiffness and can exacerbate arthritic pain. Be sure to get enough water, especially in the hot summer months when dehydration is more common. Carry a water bottle with you wherever you go and be sure to drink water throughout the day. In general, eight 8-ounce glasses of water (or non-caffeinated fluid) are needed per day.

The following recipe from Cooking Light magazine (December 2007) is a tasty summer meal that includes many of the important anti-arthritic foods:

Spice-Rubbed Roasted Salmon with Lemon-Garlic Spinach

Ingredients
SALMON:
1/2 teaspoon salt
1/2 teaspoon ground cumin
1/2 teaspoon ground coriander
1/4 teaspoon paprika
1/8 teaspoon ground cinnamon
1/8 teaspoon freshly ground black pepper
1 (2 1/4-pound) skinless salmon fillet
2 cups thinly sliced onion
Cooking spray

SPINACH:
1 teaspoon olive oil
2 garlic cloves, minced
2 (6-ounce) packages fresh baby spinach
1 teaspoon grated lemon rind
1/4 teaspoon salt
1 tablespoon fresh lemon juice

REMAINING INGREDIENTS:
2 tablespoons chopped fresh cilantro
Lemon wedges (optional)

Preparation
Preheat oven to 400°.

To prepare salmon, combine first 6 ingredients; rub spice mixture evenly over fish. Place onion in an 11 x 7-inch baking dish coated with cooking spray. Place fish on top of onion; bake at 400° for 20 minutes or until fish flakes easily when tested with a fork (or until cooked to your liking).

To prepare spinach, heat oil in a large nonstick skillet over medium heat. Add garlic to pan; cook 1 minute. Add half of spinach; cook for 1 minute, stirring frequently. Add remaining spinach; cook 4 minutes or until wilted, stirring frequently. Sprinkle spinach mixture with lemon rind and 1/4 teaspoon salt. Stir in juice; remove from heat.

Place salmon on a platter. Arrange onions and spinach evenly around salmon. Sprinkle salmon with chopped fresh cilantro. Serve with lemon wedges, if desired.

Yield: 6 servings (serving size: about 4 1/2 ounces salmon and 1/3 cup spinach mixture)

Nutritional Information:
Calories: 325; Fat: 13.2g (saturated fat - 2g, monounsaturated fat - 4.6g, polyunsaturated fat - 5g); Sodium: 472mg; Protein: 40.3g; Fiber: 3.4g

References:

Shapiro, J., Koepsell, T., Voight, L., Dugowson, C., Kestin, M., and Nelson, J. (1998). Diet and Rheumatoid Arthritis in Women: A Possible Protective Effect of Fish Consumption. Epidemiology, 7(3), 256-263.

Thedford, K. (2008). Assessment of Plasma Homocysteine and Vitamin B-6 Status in Women with Rheumatoid Arthritis. Journal of the American Dietetic Association, 108(3), 454.

Wolman, P., Smith, J., Phillian, L., Lewis, J., and Turner, A. (2005). Prevention and Treatment of Arthritis: The South Carolina Plan for Nutrition and Complementary Care. Journal of the American Dietetic Association, 105(8), 32.

The Arthritis Foundation
http://www.arthritis.org